What is meant by "patient balance" in medical billing?

The term "patient balance" in medical billing specifically refers to the remaining amount that a patient owes after insurance payments have been applied. This figure is calculated by taking the total cost of all services provided, subtracting any payments made by insurance, and accounting for any adjustments or write-offs that may have occurred.

Understanding this concept is crucial for both medical billing and patient billing practices, as it ensures clarity in the financial obligations of the patient. This balance reflects the patient’s responsibility, which may include deductibles, copayments, and any non-covered services that the insurance did not reimburse. This knowledge is essential when discussing financial responsibilities with patients or when processing billing information in an office setting.